Public Opinion on Elder Caregiving Policy: Exploring the Impact of Information

• In Event: Population Aging and Public Policy

Abstract

Most elderly Americans prefer to “age in place” but to do so often require infrastructural and human supports (Herbert & Molinksy, 2019; Miller et al., 2018). One of these supports is help from “informal” caregivers—typically family members and friends—who are called the “backbone” of America’s long-term care (LTC) system (NACDD, 2018).

Yet, U.S. public policy does not well address the risks that informal caregivers face, instead exemplifying “policy drift” (Rocco, 2017). State and federal initiatives potentially helpful to informal caregivers have proceeded unevenly and often unsuccessfully (Reinhard et al., 2019; Rocco, 2017; Thompson, Cantor & Farnham, 2016; Weissert, 2012). Insufficient supports in this area hurt elderly Americans since they put informal caregivers at risk of becoming unable to fulfill care roles for financial or health reasons. And, insufficient supports in this area particularly hurt lower-income family caregivers and care recipients (Herd, 2002; Howard, 2007), meaning that drift in this area stands to exacerbate preexisting socio-economic and health disparities. As scholars note (Campbell, 2014; Greer, 2018; Grogan & Park, 2018; Rocco, 2017), more political science research is needed on LTC and informal caregiving, and on shortcomings in this policy area.

This paper examines the public opinion side of the politics around elder caregiving policy. It specifically studies the attitudinal consequences of one phenomenon that may contribute to drift in this area: social constructions—which can reflect and shape how lawmakers and the public understand a policy’s target populations (Schneider & Ingram, 1993)—may understate the prevalence of informal caregivers in the population, particularly understating the share of men, younger Americans, older Americans, people with chronic health conditions, and people with disabilities who serve as informal caregivers for the elderly (Argyle, 2001; Jenkins, 2018; Lipson, 2015; NACDD, 2018; Reinhard et al., 2019).

Through survey experiments, this paper examines the relationship between the information about informal caregivers for the elderly that is presented (varied through random assignment), and two outcomes: (1) support for specific proposals that could help informal caregivers (and thus care recipients), and (2) assessment of the degree to which each proposal could be relevant to the respondent or to people with whom the respondent feels a connection—in other words, the degree to which the respondent sees the policy as “proximate” (Soss & Schram, 2007).

The results are relevant to public health and political science, contributing to research on health politics, aging politics, and the relationship between social constructions and policy attitudes in these areas.

References
Argyle, E. (2001). Poverty, disability and the role of older carers. Disability & Society, 16(4), 585-595.

Campbell, A. L. (2014). Trapped in America’s safety net: One family’s struggle. University of Chicago Press.

Greer, S. L. (2018). The politics of bad policy in the United States. Perspectives on Politics, 16(2), 455-459.

Grogan, C. M., & Park, S. (2018). Medicaid retrenchment politics: Fragmented or unified? JASP, 30(3-4), 372-399.

Herbert, C., & Molinsky, J. H. (2019). What can be done to better support older adults to age successfully in their homes and communities? Health Affairs, 38(5), 1-5.

Herd, P. (2002). Vertical axes on the long-term care continuum. JASP, 13(1), 37-56.

Howard, C. (2007). The welfare state nobody knows. Princeton University Press.

Jenkins, J. (2018). Millennials and caregiving? Yes, it’s a thing. AARP.

Lipson, D. J. (2015). The policy and political environment of family caregiving: A glass half full. In Family Caregiving in the New Normal, J. E. Gaugler & R. L. Kane, eds. Elsevier, pp. 137-152.

Miller, E. A., Nadash, P., Gusmano, M. K., Simpson, E., & Ronneberg, C. R. (2018). The state of aging policy and politics in the Trump era. JASP, 30(3-4), 193-208.

National Association of Chronic Disease Directors. (2018). Caregiving for family and friends—A public health issue. www.cdc.gov/aging/caregiving/caregiver-brief.html

Reinhard, S. C., Feinberg, L. F., Houser, A., Choula, R., & Evans, M. (2019). Valuing the invaluable: 2019 update. AARP. https://www.aarp.org/ppi/info-2015/valuing-the-invaluable-2015-update.html

Rocco, P. (2017). Informal caregiving and the politics of policy drift in the United States. JASP, 29(5), 413-432.

Schneider, A., & Ingram, H. (1993). Social construction of target populations: Implications for politics and policy. APSR, 87(2), 334-347.

Soss, J., & Schram, S. F. (2007). A public transformed? Welfare reform as policy feedback. APSR, 101(1), 111-127.

Thompson, F. J., Cantor, J. C., & Farnham, J. (2016). Medicaid long-term care: State variation and the intergovernmental lobby. JHPPL, 41(4), 763-780.

Weissert, W. G. (2012). A 10-food rope for a 50-yard drop: The CLASS Act in the Patient Protection and Affordable Care Act. JASP, 24(2), 136-151.

Author

• Jacqueline M. Chattopadhyay, University of North Carolina at Charlotte